Medical Education最新文献

{"title":"Sculpting the good surgeon or excising the bad one: How clinical teachers could perpetuate attrition in surgical residency programmes.","authors":"Arlen Astrid Rada-Estarita, María Camila Rincón-Ortiz, Oscar Geovanny Hernández-Rodríguez, Francisco Manuel Olmos-Vega","doi":"10.1111/medu.15557","DOIUrl":"https://doi.org/10.1111/medu.15557","url":null,"abstract":"<p><strong>Introduction: </strong>Attrition in surgical residencies remains a significant issue, with traditional research focusing mainly on individual and programme factors. This study explores the role of clinical teachers (CTs) in influencing attrition rates. CTs are essential in moulding residents' training, serving both as enablers of workplace learning and guardians of their medical fields.</p><p><strong>Methods: </strong>We employed a hermeneutic phenomenology framework to understand the sociocultural impacts on attrition. Data were collected through semi-structured interviews involving 19 CTs, 3 residents who left the programme and 2 who underwent remediation, following a six-step hermeneutic phenomenological analysis process.</p><p><strong>Results: </strong>The entrenched 'good surgeon' narrative within the department demanded selflessness and total dedication, which CTs reinforced, thereby normalising a rigorous and challenging environment. This has led to attrition when residents fail to meet these challenges or choose to disengage from the system. We illustrated that CTs were pivotal in perpetuating these expectations, contributing significantly to resident attrition.</p><p><strong>Conclusions: </strong>CTs played a crucial role in resident attrition by enforcing a stringent cultural norm within surgical training programmes. Addressing this issue requires a visible change in CTs' role to foster a more supportive educational environment. Emphasising the beneficial aspects of the 'good surgeon' narrative and mitigating its adverse impacts is essential for reducing attrition rates and assisting all residents, including those facing challenges, in successfully completing their training.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards representation: Empowering youth and their community network with education.","authors":"Maggie Kerr Livingstone, Bethan Macdonald, Valerie Isobel Rae","doi":"10.1111/medu.15561","DOIUrl":"https://doi.org/10.1111/medu.15561","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When I say … social responsiveness.","authors":"Anthea Hansen, Susan Camille van Schalkwyk, Cecilia Jacobs","doi":"10.1111/medu.15566","DOIUrl":"https://doi.org/10.1111/medu.15566","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations of equity, diversity and inclusion in peer reviews conducted for Medical Education.","authors":"Karen E Hauer, Rola Ajjawi, Lulu Alwazzan, Kevin Eva","doi":"10.1111/medu.15560","DOIUrl":"https://doi.org/10.1111/medu.15560","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When I say … haunted curriculum.","authors":"David A Ansari, Neera R Jain, Constance R Tucker, Jennifer Karlin","doi":"10.1111/medu.15537","DOIUrl":"https://doi.org/10.1111/medu.15537","url":null,"abstract":"<p><p>As medical and health professions education (HPE) fields shift towards frameworks of justice, equity, diversity and inclusion (JEDI), there has been an increased focus on addressing the environments of learning to understand hierarchies of power and create better learning experiences for students who have historically been marginalised in these fields. We propose the haunted curriculum as an evocative conceptual framing to engage with the aspects of medical and HPE that are toxic and troubling to learners and to understand how violent histories continue to loom large and permeate the present. The haunted curriculum examines how forms of oppression and injustice, such as racism and ableism, are always ever-present and often arise in unexpected ways during training. The haunted curriculum also helps to uncover how environments of training and professionalisation may themselves inflict these forms of oppression and injustice and may be ideal spaces to counter them.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When words fail us: An integrative review of innovative elicitation techniques for qualitative interviews.","authors":"Renate Kahlke, Lauren A Maggio, Mark C Lee, Sayra Cristancho, Kori LaDonna, Zahra Abdallah, Aakashdeep Khehra, Kushal Kshatri, Tanya Horsley, Lara Varpio","doi":"10.1111/medu.15555","DOIUrl":"https://doi.org/10.1111/medu.15555","url":null,"abstract":"<p><strong>Introduction: </strong>Interviews are central to many qualitative studies in health professions education (HPE). However, researchers often struggle to elicit rich data and engage diverse participants who may find this strategy exclusionary. Elicitation techniques are strategies tailored to address these challenges, enhancing oral conversations through other forms of interaction-for example, participant photography and neighbourhood walks. These strategies are tailored to elicit the rich data needed to address complex problems and meaningfully engage participants. Unfortunately, guidance on these techniques is scattered across literatures from diverse fields. In this synthesis, we offer an overview of the elicitation techniques available and advice about how to choose between them.</p><p><strong>Methods: </strong>We conducted an integrative review, drawing on methodological literature from across the health and social sciences. Our interdisciplinary searches yielded 3056 citations. We included 293 citations that were methodologically focused and discussed elicitation techniques used in interviews with adults. We then extracted specific elicitation techniques, summarising each technique to capture key features, as well as strengths and weaknesses. From this, we developed a framework to help researchers identify challenges in their interview-based research and to select elicitation techniques that address their challenges.</p><p><strong>Results: </strong>To enrich data, researchers might seek to shift conversations away from participants' entrenched narratives, to externalise conversations on sensitive topics, or to elicit affect, tacit knowledge or contextual details. When empowering participants, researchers might seek to increase equity between the researcher and participant or foster interview accessibility across diverse participant populations.</p><p><strong>Discussion: </strong>When chosen with study goals in mind, elicitation techniques can enrich interview data. To harness this potential, we need to re-conceptualise interviews as co-production of knowledge by researcher(s) and participant(s). To make interviews more equitable and accessible, we need to consider flexibility so that each participant can engage in ways that best suit their needs and preferences.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dialogues across difference: Teaching for social justice and inclusion in health professions education.","authors":"Arno K Kumagai, Umberin Najeeb","doi":"10.1111/medu.15556","DOIUrl":"https://doi.org/10.1111/medu.15556","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When I say …. Respectful curiosity.","authors":"Amaya Ellawala, Enam Haque","doi":"10.1111/medu.15552","DOIUrl":"https://doi.org/10.1111/medu.15552","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Dancing with emotions': An Interpretive Descriptive study of facilitators recognition and response to students' emotions during simulation.","authors":"Claudia C Behrens, Diana H Dolmans, Erik W Driessen, Gerard J Gormley","doi":"10.1111/medu.15554","DOIUrl":"https://doi.org/10.1111/medu.15554","url":null,"abstract":"<p><strong>Introduction: </strong>Immersive simulations can evoke a range of emotions in students. However, little is known about how facilitators recognise and respond to students' emotions during simulations. This study aims to understand how simulation facilitators perceive and respond to students' emotions during simulation-in order to optimise learning.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with 10 simulation facilitators who had varying experiences in simulation-based practice. We explored their experiences of students' emotions in simulations and reactions to these perceived emotional states. Applying an Interpretive Descriptive methodology, drawing upon control-value theory, we iteratively and reflexively developed themes to address our research question. Based on a contrasting analysis, we used the concept of 'crafted stories' to represent our findings.</p><p><strong>Results: </strong>We identified three recurring issues and crafted these into stories: (1) facilitators that recognise emotions and adjust the complexity of the simulation in order to dampen intense negative emotions and 'preserve learning'; (2) those that recognise mainly negative emotions and argue that it is better to let them feel the 'heat' in order to prepare them for the realities of clinical practice; (3) those that recognise both negative and positive emotions but let the simulation run as planned for all learners and attend to emotional responses during debriefing.</p><p><strong>Conclusion: </strong>Simulation facilitators become aware of students' emotional responses through a range of cues. While some facilitators continually move and react to students' emotions, others intentionally hold back from attempting to alter students' emotional responses. Facilitators' beliefs about how to optimise learning mediate how they react to students' emotional states. Beliefs about learning are predominantly shaped by their experiences in both teaching and real-world clinical practice. By understanding the delicate balancing act of students' emotional states and altering the complexity of a simulation, we have the opportunity to inform facilitator training in order to enhance learning.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142469418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"November in this issue","authors":"","doi":"10.1111/medu.15547","DOIUrl":"https://doi.org/10.1111/medu.15547","url":null,"abstract":"&lt;p&gt;This interview study of medical students, residents and fellows probes the language they use to talk about the—sometimes invisible, but still powerful—‘everyday’ ways they resist oppression and make change. These trainees narrate their resistance work as an almost physical pushing back against racism, sexism and homophobia; an embodied standing up to the status quo; and a verbal and cognitive bringing of these inequities to light for those being harmed. This study provides a window into the vital work of trainees; if you can see this work for what it is, you can step up and join it.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Konopasky, A&lt;/span&gt;, &lt;span&gt;Ma, T&lt;/span&gt;, &lt;span&gt;Wyatt, T&lt;/span&gt;. &lt;span&gt;Pushing, standing, and bringing to light: how medical trainees conceptualize professional resistance&lt;/span&gt;. &lt;i&gt;Med Educ&lt;/i&gt;. &lt;span&gt;2024&lt;/span&gt;; &lt;span&gt;58&lt;/span&gt;(&lt;span&gt;11&lt;/span&gt;): &lt;span&gt;1343&lt;/span&gt;-&lt;span&gt;1349&lt;/span&gt;. 10.1111/medu.15400.&lt;/p&gt;&lt;p&gt;Translating HPER findings through the emotive and embodied nature of a verbatim theatre performance creates alternative learning spaces for rich and valuable insights that aligns with transformative pedagogy. The authors describe the experiential process of bringing an interdisciplinary team together to craft a verbatim theatre script from a qualitative data set on professionalism and sociocultural factors in health professions education (HPE). They share research and pedagogical insights, including key opportunities and challenges they encountered in translating HPER to support transformative pedagogy and practice in HPE.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Brand, G&lt;/span&gt;, &lt;span&gt;Peters, S&lt;/span&gt;, &lt;span&gt;Dart, J&lt;/span&gt;. &lt;span&gt;Verbatim theatre as a creative approach to health professions education research translation&lt;/span&gt;. &lt;i&gt;Med Educ&lt;/i&gt;. &lt;span&gt;2024&lt;/span&gt;; &lt;span&gt;58&lt;/span&gt;(&lt;span&gt;11&lt;/span&gt;): &lt;span&gt;1296&lt;/span&gt;-&lt;span&gt;1303&lt;/span&gt;. 10.1111/medu.15449.&lt;/p&gt;&lt;p&gt;Since the release of ChatGPT, the advent of large language models has become an inexorable part of our society, fundamentally changing how we interact with technology, access information and approach education. This review critically analyses the implications of large language models in medical education, considering the benefits and limitations of ethical and practical implementation. Studies highlight LLMs theoretical potential and offer quantitative analyses, emphasising its value as a tool but not as a substitute for human expertise.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Robinson, JR&lt;/span&gt;, &lt;span&gt;Lucas, HC&lt;/span&gt;, &lt;span&gt;Upperman, JS&lt;/span&gt;. &lt;span&gt;A systematic review of large language models and their implications in medical education&lt;/span&gt;. &lt;i&gt;Med Educ&lt;/i&gt;. &lt;span&gt;2024&lt;/span&gt;; &lt;span&gt;58&lt;/span&gt;(&lt;span&gt;11&lt;/span&gt;): &lt;span&gt;1276&lt;/span&gt;-&lt;span&gt;1285&lt;/span&gt;. 10.1111/medu.15402.&lt;/p&gt;&lt;p&gt;To be silenced, disbelieved or not taken seriously as a knower is both a deep source of distress and a form of dehumanisation. In this article, the authors unpack the philosophical concept of epistemic injustice and ","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 11","pages":"1259"},"PeriodicalIF":4.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15547","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}